How poverty is leading to the return of historic diseases like gout and rickets

Experts call for political leadership to deal with the crisis of poverty as Victorian diseases return to the region

Prof John Ashton
Prof John Ashton

As a young doctor in the 1960s, John Ashton cut his medical teeth in Newcastle.

One of the things he remembers most was the amount of men he treated who had grown up in the 1920s and 30s and were so short.

“When I worked in Newcastle I saw all these short Geordie men who were only about 5ft tall. They were so short in stature because of poverty and nutritional deficiencies in their diet,” he said.

And now, 50 years on, he fears the current state of the economy could see a new generation of North East youngsters raised in growing poverty and, growing into adulthood, similarly afflicted.

“If something isn’t done, that could happen again” he warned.

Dr Ashton belongs to the UK Faculty of Public Health which has created waves by highlighting the return of diseases which many thought had been consigned to the history books, namely rickets and gout which affect the bones and joints.

“We had heard about this and when I attended a meeting of GPs and asked ‘is this true?’ they said it was.”

These Dickensian-sounding maladies are part of the same issue which could see the return of the diminutive Geordie - poverty.

“It’s terrible that in a country where there are so many wealthy people there are still so many in poverty,” he said.

“There are a lot of people stuck at the bottom. About 20% stuck in poverty, not least in the North East.”

As a result, it is appealing to all political parties to back a living wage to help combat one of the root causes of the issue.

And the FPH is also calling for a national food policy, including a sugar tax, because of concerns over malnutrition and vitamin deficiencies in British children.

According to Dr Ashton, what is needed is political leadership in a society which, he fears, has become uncaring about the suffering of the less well-off.

“It seems that as a society we’ve begun to become callous and hardened against hardship and poverty. We’ve become very selfish,” he said.

He referred specifically to the political row earlier this year when it was claimed people were using foodbanks, not because they were desperate for food, but to save themselves a bit of cash.

“They ignored the fact these wonderful people running the foodbanks showed there was still humanity out there,” he said.

“The political consensus on those who used foodbanks was that it was their own fault.”

The FPH isn’t the only body addressing this issue. And poverty isn’t just about food, it affects the life opportunities of the youngsters too.

In the autumn, the Children’s Commission on Poverty, is due to publish the findings of its 18-month inquiry.

It is understood it will reveal parents are increasingly struggling to pay for their children’s school uniform, lunches and study equipment, revealing an ever-increasing gulf between children from low-income families and those from high-income homes.

With the start of the new academic year many will find they cannot afford to pay for their children’s school trips, musical instruments and art materials.

Sarah Bryson
Sarah Bryson

Sarah Bryson, a school poverty specialist with the charity Children North East, who gave evidence at one of the commission’s three parliamentary hearings this summer, said increasing numbers of children – not just those entitled to free school meals – faced social isolation, bullying and narrowing academic opportunities because they were unable to participate fully in school activities.

“The inequality between the haves and have-nots is more stark now. Schools reflect society and we are living in a time of great inequality. These schools are a microcosm of that,” Ms Bryson said.

In 2011 Children North East invited kids to take a series of pictures to illustrate poverty and they made quite an impact when they formed part of an exhibition at the Sage Gateshead.

It features the likes of empty fridges, down-at-heel shoes and boarded up windows.

“They said if you’re poor you stand out at school,” said Sarah. “You’re picked on because you haven’t got the right school uniform or you have free school meals.”

With the childrens’ help, Children North East came up with an action plan to ‘poverty proof’ schools which has been rolled out to 10 schools in the region in the last year. It has also been asked to contribute to the Children’s Commission on Poverty’s report which will be published in October.

“It’s poverty from a child’s point of view,” said Sarah.

And, as with the FPH, they are backing calls for the Living Wage.

“The Labour Government removed a million kids from poverty thanks largely to tax credits. Due to recent changes to tax credits, the amount of children in poverty has gone up by a million. It’s not rocket science.”

While the publication of Children’s Commission on Poverty report is not due for a few weeks, the comments by the FPH followed an open letter sent in May to Prime Minister David Cameron and published in the respected Lancet magazine, in which they laid out their fears about the debilitating health effects of poverty on children.

It spoke of the “worrying gap in health circumstances and outcomes between rich and poor people in the UK”.

The letter said that “the reality is that many hardworking families in the UK are living in poverty and do not have enough income for a decent diet. UK food prices have risen by 12% in real terms since 2007, returning the cost of food relative to other goods to that in the 1990s.

“In the same period, UK workers have suffered a 7.6% fall in real wages.

“It therefore seems likely that increasing numbers of people on low wages are not earning enough money to meet their most basic nutritional needs to maintain a healthy diet.

“We should not accept this situation in the UK, the world’s sixth largest economy and the third largest in Europe.”

The letter was signed by more than 100 health officials including Prof Eugene Milne, director of Public Health at Newcastle City Council.

He said: “In Newcastle we have seen a rise in the numbers of people using foodbanks, and evidence suggests it reflects genuine need.

“This local increase reflects the picture across the country. Rising food and fuel prices combined with wages and income that are stagnant or falling, mean that some people are struggling to afford decent food or the fuel to cook it.

“A healthy diet is a prerequisite for a healthy lifestyle. But when times are hard we see people choosing instead cheaper, high calorie, processed food that can contribute to obesity and conditions such as diabetes.

“In Newcastle our public health programmes are working in partnership to support people to eat healthily in the face of these problems. Ensuring that people have access to good, healthy food is fundamental to public health.”

Dr John Middleton, from the FPH, said obesity remains the biggest problem of food poverty as families are forced into choosing cheap, processed high fat foods just to survive.

“It’s getting worse because people can’t afford good quality food,” he said. “Malnutrition, rickets and other manifestations of extreme poor diet are becoming apparent. It is a condition we believed should have died out.

“The vitamin deficiency states of gout, malnutrition being seen in hospital admission statistics are extreme manifestations of specific dietary deficiencies or excesses, but they are markers of a national diet which is poor.”

The UK has 3.8 million children in extreme poverty. Charities such as the Trussell Trust report growing need for foodbanks but say that some of the items donated can be of poor quality.

Dr Middleton said: “If the nutritional diseases are markers of a poor diet, the food banks are markers of extreme poverty - the evidence from Trussell Trust suggests the biggest group of users are hard working poor families who have lost benefits, live on low and declining wages and or they have fallen foul of draconian benefits sanctions which propel them into acute poverty and hunger.

“This is a disastrous and damning indictment on current welfare policy and a shame on the nation. The food banks are providing a real and valued service staving off actual hunger – they are actually keeping people alive.”

The FPH is calling for an independent working group to monitor nutrition and hunger in the UK.

Prof Ashton added: “This issue needs to get into the political debate over the next 10 months before the next general election to get the parties to spell out what they are going to do about it.”


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